Individual
DERRICK E RIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 COLISEUM DR, SUITE 100, HAMPTON, VA 23666-5906
(757) 827-2200
(757) 827-2266
Mailing address
4000 COLISEUM DR, SUITE 100, HAMPTON, VA 23666-5906
(757) 827-2200
(757) 827-2266
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101033473
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006071147
—
VA
Enumeration date
05/01/2006
Last updated
02/24/2011
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